Organization
INVISTA OPTICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA JAHNKE OD (OWNER/OPTOMETRIST)
(765) 346-0852
Entity
Organization
Contact information
Practice address
640 E MICHIGAN ST STE B, INDIANAPOLIS, IN 46202-0007
(317) 929-1401
(317) 929-1399
Mailing address
3416 ROYAL OAK DR, INDIANAPOLIS, IN 46227-7075
(765) 346-0852
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003798
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201205510
—
IN
Enumeration date
10/16/2015
Last updated
12/07/2016
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